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The game takes place in 2281, 4 years after the events of Fallout 3 in the former Las Vegas, who managed to ride out the Great War and the subsequent Dark Ages is better preserved than other regions. In the game there is a conflict between the mysterious ruler of New Vegas - Mr. House, the New California Republic, Caesar's Legion slave, where each party tries to take over Hoover Dam - a giant hydroelectric plant on the Colorado River, the supply of electricity throughout the region.
The protagonist - a courier working in the company "Mohavsky Express" and has no relation to shelters, delivering another parcel (platinum chip for the casino) is ambushed by an unknown gang and have to die without sending the remains in a shallow grave. There, he finds and digs robot sekyuritron Victor, then assigns the hero in the town of Goodsprings local Dr. Mitchell. Doc cures hero spends a couple of interviews and tests (including the Rorschach test), gives him the Pip-Boy, returns the equipment and weapons, and send into the Wasteland. One of the primary tasks of the protagonist - to find out what is needed, this feature platinum and who tried to kill him...